SHARED Tool – Communication Tool for ED Health Care Providers & Youth Workers
An intersectoral working group was formed following concerns raised by BC Children’s Hospital Emergency Department, BC Children’s Hospital RICHER Initiative (Responsive Intersectoral Interdisciplinary Community Health Education and Research, also known as the “Social Pediatrics” initiative), and youth-serving professionals in the community. The goal was to increase our ability to secure follow up and ensure a safe discharge for vulnerable youth who present to the BCCH Emergency Department unaccompanied, in crisis, and often impacted by multiple social determinants of health (e.g. poverty, unstable housing, family stressors, and/or complex trauma).
The “RICHER – BCCH Emergency Department Vulnerable Youth Working Group” was formed and membership extended to include the Emergency Department, Division of Adolescent Health and Medicine, Mental Health Services and Social Work at BC Children’s Hospital, the Ministry for Child and Family Development, Vancouver Aboriginal Child and Family Services Society, Network of Inner City Community Services Society and other community agencies.
Confidential case reviews of youth known to the community agencies, who had presented frequently to the Emergency Department, were done to determine challenges, gaps in care and provided a framework for the Committee to work within. Inadequate communication was identified between community supports and the Emergency Department. Baseline data from a community generated youth cohort demonstrated that community agencies were routinely identifying vulnerable youth who present frequently to the Emergency Department.
The SHARED (Situation, History, Assessment, Recommendation, Disposition) Script (figure 1) for Community-Emergency Department Communication was developed by the Committee.
- The format of the tool is based in SBARD (Situation, Background, Assessment, Recommendation, Decision), follows the sequence of the Physician Assessment and has 12 questions.
- The information is provided to the Emergency Department via a phone call, directly from the Community Worker to the Physician or Charge Nurse prior to the patient arriving.
- Community Agencies and Workers have a laminated card sized copy of the tool and questions to ensure all relevant information is shared effectively.
- Training sessions have been facilitated for Community Agencies regarding the use of this tool and an evaluative process established.
The Working Group presented at University of British Columbia / BC Children’s Hospital Pediatric Grand Rounds on October 13, 2017. The video of the presentation is available at:
Written by: Caroline Chilvers, Simran Grewal, Garth Meckler, Vikram Sabhaney, and Dzung Vo.